Chen T Y, Chen K T, Chang D P, Yeh F C, Chang C L
Department of Anesthesia, National Chen-Kung University Medical College and Hospital, Taiwan, R.O.C.
Acta Anaesthesiol Sin. 1994 Mar;32(1):27-30.
Unintentional hypothermia is common in patients undergoing "routine anesthesia in surgery". The aims of the study were to estimate the difference of changes of body temperature during abdominal and limb operations and to evaluate the effectiveness of the heated humidifier for reducing intraoperative heat loss. Forty-three patients were randomly being allocated into 3 groups. Group I consisted of 14 patients undergoing abdominal operation without the use of heated humidifier. Another 22 patients were being assigned as group II to have a heated humidifier on the inspiratory limb of the breathing circuit. The inspired gas was warmed to 39 degrees C and the relative humidity was 90%. 7 patients undergoing limb operation were attributed to group III without using heated humidifier to humidify and warm up the inspired gas. For body temperature monitoring, the probe was placed on the patient's nasopharynx and the temperature was measured immediately before induction of anesthesia, post-intubation, and then once again every 15 minutes up to 3 hours after induction. All patients in the 3 groups showed a rapid decrease of body temperature in the first hour and then the hypothermic change was slow down. The lowest level of body temperature was reached at about 2 hours after induction. Patients undergoing abdominal operation decreased body temperature greater than those undergoing limb operation for about 2 degrees C after 3 hours of anesthesia and surgery. Warming and humidifying the inspired gas effectively reduced the heat loss. We concluded that abdominal operation induce hypothermia more than limb operation. The use of heated humidifier was effective in maintaining body temperature.
在接受“外科常规麻醉”的患者中,意外体温过低很常见。本研究的目的是评估腹部手术和肢体手术期间体温变化的差异,并评估加热湿化器减少术中热量损失的有效性。43例患者被随机分为3组。第一组由14例接受腹部手术且未使用加热湿化器的患者组成。另外22例患者被分配到第二组,在呼吸回路的吸气支上使用加热湿化器。吸入气体被加热到39摄氏度,相对湿度为90%。7例接受肢体手术的患者被归入第三组,未使用加热湿化器对吸入气体进行湿化和加温。对于体温监测,探头置于患者鼻咽部,在麻醉诱导前、插管后立即测量体温,然后在诱导后3小时内每15分钟测量一次。3组所有患者在第一个小时内体温均迅速下降,随后体温下降速度减缓。体温最低水平在诱导后约2小时达到。麻醉和手术后3小时,接受腹部手术的患者体温下降幅度比接受肢体手术的患者大约2摄氏度。对吸入气体进行加温和湿化可有效减少热量损失。我们得出结论,腹部手术比肢体手术更容易导致体温过低。使用加热湿化器对维持体温有效。